Objective: We
conducted a large
observational study
in 193 children and
adolescents with
allergic rhinitis
due to grass or tree
pollens to evaluate
the safety and
tolerability of an
ultrarush high-dose
sublingual
immunotherapy (SLIT)
regimen reaching a
maintenance dose of
300 index of
reactivity within 90
minutes.

Methods:
Children and
adolescents aged 5
to 17 years with at
least a 1-year
medical history of
allergic rhinitis
with or without mild
to moderate asthma
due to tree pollens
(birch, alder,
hazel) or grass
pollens (cocksfoot,
meadow grass, rye
grass, sweet vernal
grass, timothy) were
recruited.
Standardized grass
and tree pollen
allergen extracts
were used for
ultrarush titration
and subsequent
coseasonal
maintenance.

Results:
During ultrarush
titration, 60
patients (31%)
reported 117
predominantly mild
and local adverse
events, which
resolved within 150
minutes. During the
maintenance phase,
562 adverse events
were reported; the
most frequent local
events were oral
pruritus, burning
sensation, lip or
tongue swelling, and
gastrointestinal
symptoms, and the
most frequent
systemic events were
rhinoconjunctivitis
and asthma. There
was 1 clinically
significant asthma
event in an 11-year
old boy with known
asthma in whom SLIT
was resumed after an
interval of 4 days.

Conclusion:
Ultrarush titration
was safe and well
tolerated. Pediatric
patients with asthma
should be carefully
monitored and
adequately trained
to use their rescue
medications.